Night eating and loss of control over eating in bariatric surgery candidates.

The goal was to examine the relationship between loss of control over eating (LOCE) and other variables, including eating pathology, in bariatric candidates. Two hundred and twenty-six participants completed measures of depressive symptoms, eating pathology, health-related quality of life (HRQOL), and alcohol use. Participants were divided into those who did (n = 123) and did not (n = 103) report subjective LOCE. Participants with LOCE had significantly higher levels of night eating, depressive symptoms, and eating disorder psychopathology and lower mental HRQOL. There were no observed differences in alcohol use, dietary restraint, or physical HRQOL. This study highlights eating and mental health-related correlates of LOCE, providing evidence that it is associated with increased psychological burden in bariatric candidates. This is one of the first studies to report the relationship between LOCE and night eating in this group and future research could elaborate on these variables to determine their importance in long-term weight loss.

Psychometric properties of the Patient Health Questionnaire (PHQ-9) as a depression screening tool for bariatric surgery candidates.

BACKGROUND: Major depressive disorder has been shown in some studies to attenuate weight loss and psychosocial outcomes following surgery. Given the potential implications of depression on surgery outcomes, presurgery psychiatric assessment is recommended to assess suitability for bariatric surgery. OBJECTIVES: The purpose of this study was to examine the accuracy of the Patient Health Questionnaire-9 (PHQ-9) in detecting depression in bariatric surgery candidates. METHODS: Bariatric surgery candidates (n = 244) completed the PHQ-9 and the Mini International Neuropsychiatric Interview (MINI) as part of their presurgery psychiatric assessment. The operating characteristics of the PHQ-9 were examined. The study was replicated in an independent sample of bariatric surgery candidates (n = 275). RESULTS: Rates of current and lifetime major depressive episodes were 1.6% to 3.8% and 33.8% to 35.5%, respectively, as assessed by the MINI. According to the PHQ-9, 52.5% to 54.9% of patients exceeded the cutoff for moderate depression (PHQ-9 ≥ 10), and 27.6% to 29.1% for moderate severe depression (PHQ-9 ≥ 15). The optimal dichotomization cutoff point on the PHQ-9 was ≥15 in both studies (sensitivity 75%, specificity 75% to 76%). CONCLUSIONS: Our results suggest that the PHQ-9 has adequate operating characteristics compared with a criterion standard measure. A PHQ-9 cutoff of 15 is recommended to identify bariatric surgery candidates who may require further assessment of depressive symptoms.

Rapid and slow responders to eating disorder treatment: a comparison on clinically relevant variables.

OBJECTIVE: Speed of response to eating disorder treatment is a reliable predictor of relapse, with rapid response predicting improved outcomes. This study investigated whether rapid, slow, and nonresponders could be differentiated on clinically relevant variables, and possibly identified prior to treatment. METHOD: Female patients (N = 181) were classified as rapid, slow, or nonresponders based on the speed and magnitude with which they interrupted their bingeing and/or vomiting symptoms, and were compared on eating disorder behaviors and psychopathology and general psychopathology. RESULTS: The rapid response group was marginally older and had a slightly shorter course of treatment than the slow response group. The rapid response group also had significantly fewer pretreatment binge episodes, and a longer course of treatment than the nonresponse group. However, the three response groups were not significantly different on any other examined variables. DISCUSSION: The only pretreatment variable that differentiated response groups was symptom frequency, in that rapid responders had fewer binge episodes than nonresponders. No pre-existing variables differentiated rapid and slow response. Given that few individual pre-existing differences that might account for speed of response were identified, the clinical importance of facilitating a rapid response to treatment for all patients is discussed.

The Family Fat Talk Questionnaire: development and psychometric properties of a measure of fat talk behaviors within the family context.

Fat talk has been well studied in female peer groups, and evidence suggests it may also be important in family contexts. However, no instrument exists to validly assess fat talk within the family. The purpose of this study was to develop a measure of fat talk within families and to establish its psychometric properties in young adult women. In Study 1, the Family Fat Talk Questionnaire (FFTQ) was developed and exploratory factor analysis suggested a 2-factor structure ("Self" and "Family" fat talk), and strong internal consistency. Study 2 confirmed its 2-factor structure using confirmatory factor analysis. Study 3 demonstrated the construct validity of FFTQ scores, including significant correlations with related constructs and predictable gender differences. Study 4 demonstrated the stability of FFTQ scores over two weeks. Therefore, the FFTQ produces valid and reliable scores of fat talk behaviors both exhibited and observed by young adult women within the family context.

Development and validation of the Fat Talk Questionnaire.

Fat talk refers to negative body-related conversations between girls or young women. This research aimed to use qualitative data from young women to guide development of a quantitative fat talk measure. In Study 1, a preliminary 62-item questionnaire was developed and administered to 200 female participants. Item analysis resulted in the elimination of items, yielding a final questionnaire with 14 items. Principal components analysis of this questionnaire indicated a single factor. In Study 2, 95 female participants completed the newly developed Fat Talk Questionnaire and theoretically related (e.g., body image) and unrelated (e.g., social desirability) constructs. Additionally, 49 male participants completed the questionnaire to examine known groups validity. In Study 3, 54 participants completed the Fat Talk Questionnaire on two occasions to assess temporal stability. The results showed that the Fat Talk Questionnaire is reliable and valid. The Fat Talk Questionnaire may have important utility in future research.